End of Life Care: Helping patients document their wishes is really important. There are many different ways to document a patients wishes. California POLST (with form downloads) - Physician Orders for Life-Sustaining Treatment (POLST) - A quick form to fill out, but more detailed than simply "Full code" vs "DNR/DNI"
Must be signed by both physician and decision maker.
Copies are of completed forms are valid, however, it is preferable to have the original completed on pink paper if possible.
Contra Costa Fall Prevention Program. People over 60 years old, they will send an OT to do an assessment and then install any needed assistive devices. For patients without paid caregivers (i.e. no IHSS).
This page has been edited 16 times. The last modification was made by - drshah05 on Mar 2, 2015 2:02 pm
Geriatrics Tools
"Quick" Outpatient Geriatrics Screening templateEnd of Life Care: Helping patients document their wishes is really important. There are many different ways to document a patients wishes.
California POLST (with form downloads) - Physician Orders for Life-Sustaining Treatment (POLST) - A quick form to fill out, but more detailed than simply "Full code" vs "DNR/DNI"
- Must be signed by both physician and decision maker.
- Copies are of completed forms are valid, however, it is preferable to have the original completed on pink paper if possible.
Low Literacy Forms from IHA Institute.5 Wishes: Proprietary forms, can't be printed. Needs to be ordered. An easy to use guide for patients and families. Other languages.
California DMV Medical Conditions page with PDF copy of "Request for Re-examination" form: DMV
Multipurpose Senior Services Program (MSSP): Community based resources to keep frail elderly with Medi-cal out of nursing homes.
Contra Costa Fall Prevention Program. People over 60 years old, they will send an OT to do an assessment and then install any needed assistive devices. For patients without paid caregivers (i.e. no IHSS).
This page has been edited 16 times. The last modification was made by -